Kei Hosoda1, Hideki Ushiku2, Chikatoshi Katada3, Kenji Ishido3, Masahiro Niihara2, Mikiko Sakuraya2, Ippeita Araki2, Marie Washio2, Hiroki Harada2, Keishi Yamashita4, Naoki Hiki2. 1. Department of Upper Gastrointestinal Surgery, Kitasato University School of Medicine, Kitasato 1-15-1, Minami-ku, Sagamihara, 252-0374, Japan. k.hosoda@kitasato-u.ac.jp. 2. Department of Upper Gastrointestinal Surgery, Kitasato University School of Medicine, Kitasato 1-15-1, Minami-ku, Sagamihara, 252-0374, Japan. 3. Department of Gastroenterology, Kitasato University School of Medicine, Sagamihara, Japan. 4. Division of Advanced Surgical Oncology, Research and Development Center for New Medical Frontiers, Kitasato University School of Medicine, Sagamihara, Japan.
Abstract
PURPOSE: Postoperative infectious complications have a negative impact on survival outcomes in patients with gastric cancer. It is recently reported that preoperative chemotherapy may eliminate this negative impact. This study aimed to confirm whether preoperative chemotherapy can eliminate the negative impact of postoperative infectious complications (IC) on survival outcomes and elucidate the association between postoperative infectious complications and recurrence patterns. METHODS: We retrospectively reviewed data of 86 patients who received preoperative chemotherapy with docetaxel, cisplatin, and S-1 followed by R0 gastrectomy at the Kitasato University between 2006 and 2016. Patients who developed grade II or higher infectious complications during hospitalization were grouped into the IC group, while others were grouped into the non-IC (NIC) group. Survival outcomes and recurrence patterns were analyzed between the two groups. RESULTS: Infectious complications with Clavien-Dindo classification of grade II or higher were found in 12 patients (14.0%, IC group). The median observational period was 61 months. Overall survival and progression-free survival were similar in the IC and NIC groups. Recurrence occurred in 39 patients. The proportions of peritoneal and lymph node recurrences were not significantly different between the two groups. However, the proportion of distant metastasis in the IC group was significantly higher than that in NIC group (3/4 [75%] vs. 9/35 [17%], p = 0.04). CONCLUSIONS: Pathological stage after neoadjuvant therapy plays a stronger role in recurrence than postoperative complications. Lymph node and peritoneal metastasis may be suppressed by preoperative chemotherapy.
PURPOSE:Postoperative infectious complications have a negative impact on survival outcomes in patients with gastric cancer. It is recently reported that preoperative chemotherapy may eliminate this negative impact. This study aimed to confirm whether preoperative chemotherapy can eliminate the negative impact of postoperative infectious complications (IC) on survival outcomes and elucidate the association between postoperative infectious complications and recurrence patterns. METHODS: We retrospectively reviewed data of 86 patients who received preoperative chemotherapy with docetaxel, cisplatin, and S-1 followed by R0 gastrectomy at the Kitasato University between 2006 and 2016. Patients who developed grade II or higher infectious complications during hospitalization were grouped into the IC group, while others were grouped into the non-IC (NIC) group. Survival outcomes and recurrence patterns were analyzed between the two groups. RESULTS: Infectious complications with Clavien-Dindo classification of grade II or higher were found in 12 patients (14.0%, IC group). The median observational period was 61 months. Overall survival and progression-free survival were similar in the IC and NIC groups. Recurrence occurred in 39 patients. The proportions of peritoneal and lymph node recurrences were not significantly different between the two groups. However, the proportion of distant metastasis in the IC group was significantly higher than that in NIC group (3/4 [75%] vs. 9/35 [17%], p = 0.04). CONCLUSIONS: Pathological stage after neoadjuvant therapy plays a stronger role in recurrence than postoperative complications. Lymph node and peritoneal metastasis may be suppressed by preoperative chemotherapy.
Authors: Salah-Eddin Al-Batran; Nils Homann; Claudia Pauligk; Thorsten O Goetze; Johannes Meiler; Stefan Kasper; Hans-Georg Kopp; Frank Mayer; Georg Martin Haag; Kim Luley; Udo Lindig; Wolff Schmiegel; Michael Pohl; Jan Stoehlmacher; Gunnar Folprecht; Stephan Probst; Nicole Prasnikar; Wolfgang Fischbach; Rolf Mahlberg; Jörg Trojan; Michael Koenigsmann; Uwe M Martens; Peter Thuss-Patience; Matthias Egger; Andreas Block; Volker Heinemann; Gerald Illerhaus; Markus Moehler; Michael Schenk; Frank Kullmann; Dirk M Behringer; Michael Heike; Daniel Pink; Christian Teschendorf; Carmen Löhr; Helga Bernhard; Gunter Schuch; Volker Rethwisch; Ludwig Fischer von Weikersthal; Jörg T Hartmann; Michael Kneba; Severin Daum; Karsten Schulmann; Jörg Weniger; Sebastian Belle; Timo Gaiser; Fuat S Oduncu; Martina Güntner; Wael Hozaeel; Alexander Reichart; Elke Jäger; Thomas Kraus; Stefan Mönig; Wolf O Bechstein; Martin Schuler; Harald Schmalenberg; Ralf D Hofheinz Journal: Lancet Date: 2019-04-11 Impact factor: 79.321
Authors: Freddie Bray; Jacques Ferlay; Isabelle Soerjomataram; Rebecca L Siegel; Lindsey A Torre; Ahmedin Jemal Journal: CA Cancer J Clin Date: 2018-09-12 Impact factor: 508.702